Hospital readmissions are a major, but avoidable, cost in the U.S. healthcare system, estimated at $25 billion annually.[1] Driven largely by poor discharge procedures and inadequate follow-up care, nearly one in every five Medicare patients discharged from the hospital is readmitted within 30 days.[2] Gaps in care across the healthcare continuum are further exacerbated by:
• The nation's declining number of practicing primary care physicians;
• Complications associated with treating a patient with multiple chronic conditions and continuity of care;
• Patients not being treated by their PCP once they are admitted to the hospital;
• The PCP being unfamiliar with the care the patient received while in the hospital; and
• Inadequate communication between the PCP and the hospitalist.
These challenges must be overcome in order to lower patients’' costs (additional co-pays related to readmission) and help hospitals avoid Medicare's financial readmission penalties.
Telehealth: Simple solution for a complicated problem
The new healthcare dynamic is shifting from an approach that puts more money into new facilities to treat more patients, to one that carries greater accountability and a system in which hospitals are rewarded for investing in mechanisms that improve outcomes and keep patients out of the hospital. Telehealth, the remote delivery of healthcare services using telecommunications, including phone, email, Internet and other channels, is gaining popularity among care providers as a way to streamline healthcare management and boost patient outcomes.
According to one expert, for every dollar hospitals spend using telehealth to reach out to patients post-discharge, they could potentially save $9.50 in the long run by avoiding Medicare penalties.[3]
Telehealth contributes to lowering readmissions through:
• Increased access to health services;
• Enhanced educational opportunities;
• Improved health outcomes;
• Better quality of care; and
• Enhanced social support.[4]
The telehealth approach can be further optimized by providing access to a team of healthcare providers and specialists, as well as a reward program designed to encourage individuals to follow specific protocols related to their after-care. With each step taken, such as making a follow-up appointment, filling a prescription, undergoing rehabilitation and so on, they can earn points redeemable for cash.
Connecting to remote places and underserved patients
Access to care is an important issue in remote, low population areas where the physician-to-patient ratios are inadequate and where medical specialists are also in particularly short supply. Although 20 percent of the U.S. population resides in rural areas, only nine percent of physicians and 10 percent of specialists practice in these areas.[5] Therefore, strategies for improving healthcare delivery in these underserved regions are critical.
Telehealth answers the call by allowing physicians and specialists to expand their network to areas that are difficult to reach in-person. When patients can access medical care using telehealth options, they can receive treatment for medical problems before they become critical and better manage their chronic conditions.
In terms of after-care, care managers can follow up with a patient via telephone or email to ensure the patient understands discharge instructions and has the equipment or prescriptions they need.
Finding the right telehealth platform
To optimize the advantages of telehealth, it's important to partner with a telehealth services provider that offers a product that enables healthcare delivery systems to focus on access, value and convenience. At minimum, they should include:
• Telephone and video consults
• 24/7 access to medical data
• A comprehensive network of physicians and healthcare professionals, including specialists, registered nurses, nurse practitioners, certified diabetes educators, health coaches, nutritionists and psychologist/behavioral health specialists
• A flexible business model that allows for customization of services
More robust telehealth service platforms also include:
• Consultation interface
• Electronic health record
• Unlimited 24/7 access to nurse line
• Email advice
• E-prescribing for Rx and refills and ordering of lab tests
• Auto-synchronization with EHRs
• Services available in English and Spanish, with multiple language translation options
• Incentive or reward program
The optimal telehealth program allows for the seamless assembly of a centralized, HIPAA-compliant EHR that establishes a baseline of information that can be continuously updated and shared with other providers as needed, eliminating gaps in care that stem from poor information sharing and communication between healthcare providers. The program should also include customer service representatives who gather and input data from patients, medical offices or other sources, such as labs or imaging facilities.
The number of patients who are readmitted to the hospital within a matter of weeks will continue to rise in response to poor discharge procedures, inadequate follow-up care and unnecessary healthcare utilization. Fortunately, a growing number of physicians and healthcare facilities are moving toward models of accountable care and adopting telehealth as an effective tool for managing patient safety, improving discharge procedures and optimizing after-care in order to keep costs down and realize greater shared savings. It's about bridging the gap between theoretical availability and realistic accessibility. By linking the patient to a comprehensive network of physicians, specialists and healthcare professionals, 24/7/365, telehealth delivers rapid access to care for patients when and where they need it.
A successful entrepreneur for the past 15 years, as CEO of InteractiveMD Jesse Kessler has structured and fortified many prominent partnerships, with the goal of growing the company's technologies, processes and networks, and delivering efficient, affordable and accessible healthcare. He is also the founder of Global Pharmaceutical Sourcing, a specialty pharmaceutical distribution business selling to hospitals, home infusions centers, surgery centers, blood banks, and other providers.
Footnotes:
[1] Minott, Jenny; Reducing Hospital Readmissions; Academy Health; November 2008; http://www.academyhealth.org/files/publications/ReducingHospitalReadmissions.pdf; accessed May 18, 2012.
[2] Abelson, Reed; Study finds many on Medicare Return to Hospital; New York Times; April1, 2009; http://www.nytimes.com/2009/04/02/health/02hospital.html?_r=2; accessed May 21, 2012.
[3] Gibson, Jackie Walker; Telehealth Could Boost Outcomes, Reduce Readmissions; Ignite; February 14, 2012; http://ignite.optuminsight.com/archive/telehealth-could-boost-outcomes-and-reduce-readmissions/; accessed May 21, 2012.
[4] Jennett, P. A., et al; The socio-economic impact of telehealth: a systemic review; Journal of Telemedicine and Telecare; December 1, 2003; http://www.jtt.rsmjournals.com/content/9/6/311.short; accessed May 21, 2012.
[5] Dixon, Brian E. et al; US Department of Health and Human Services; Using telehealth to improve quality and safety; December 2008; http://healthit.ahrq.gov/images/dec08telehealthreport/telehealth_issue_paper.htm; accessed May 21, 2012.
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• The nation's declining number of practicing primary care physicians;
• Complications associated with treating a patient with multiple chronic conditions and continuity of care;
• Patients not being treated by their PCP once they are admitted to the hospital;
• The PCP being unfamiliar with the care the patient received while in the hospital; and
• Inadequate communication between the PCP and the hospitalist.
These challenges must be overcome in order to lower patients’' costs (additional co-pays related to readmission) and help hospitals avoid Medicare's financial readmission penalties.
Telehealth: Simple solution for a complicated problem
The new healthcare dynamic is shifting from an approach that puts more money into new facilities to treat more patients, to one that carries greater accountability and a system in which hospitals are rewarded for investing in mechanisms that improve outcomes and keep patients out of the hospital. Telehealth, the remote delivery of healthcare services using telecommunications, including phone, email, Internet and other channels, is gaining popularity among care providers as a way to streamline healthcare management and boost patient outcomes.
According to one expert, for every dollar hospitals spend using telehealth to reach out to patients post-discharge, they could potentially save $9.50 in the long run by avoiding Medicare penalties.[3]
Telehealth contributes to lowering readmissions through:
• Increased access to health services;
• Enhanced educational opportunities;
• Improved health outcomes;
• Better quality of care; and
• Enhanced social support.[4]
The telehealth approach can be further optimized by providing access to a team of healthcare providers and specialists, as well as a reward program designed to encourage individuals to follow specific protocols related to their after-care. With each step taken, such as making a follow-up appointment, filling a prescription, undergoing rehabilitation and so on, they can earn points redeemable for cash.
Connecting to remote places and underserved patients
Access to care is an important issue in remote, low population areas where the physician-to-patient ratios are inadequate and where medical specialists are also in particularly short supply. Although 20 percent of the U.S. population resides in rural areas, only nine percent of physicians and 10 percent of specialists practice in these areas.[5] Therefore, strategies for improving healthcare delivery in these underserved regions are critical.
Telehealth answers the call by allowing physicians and specialists to expand their network to areas that are difficult to reach in-person. When patients can access medical care using telehealth options, they can receive treatment for medical problems before they become critical and better manage their chronic conditions.
In terms of after-care, care managers can follow up with a patient via telephone or email to ensure the patient understands discharge instructions and has the equipment or prescriptions they need.
Finding the right telehealth platform
To optimize the advantages of telehealth, it's important to partner with a telehealth services provider that offers a product that enables healthcare delivery systems to focus on access, value and convenience. At minimum, they should include:
• Telephone and video consults
• 24/7 access to medical data
• A comprehensive network of physicians and healthcare professionals, including specialists, registered nurses, nurse practitioners, certified diabetes educators, health coaches, nutritionists and psychologist/behavioral health specialists
• A flexible business model that allows for customization of services
More robust telehealth service platforms also include:
• Consultation interface
• Electronic health record
• Unlimited 24/7 access to nurse line
• Email advice
• E-prescribing for Rx and refills and ordering of lab tests
• Auto-synchronization with EHRs
• Services available in English and Spanish, with multiple language translation options
• Incentive or reward program
The optimal telehealth program allows for the seamless assembly of a centralized, HIPAA-compliant EHR that establishes a baseline of information that can be continuously updated and shared with other providers as needed, eliminating gaps in care that stem from poor information sharing and communication between healthcare providers. The program should also include customer service representatives who gather and input data from patients, medical offices or other sources, such as labs or imaging facilities.
The number of patients who are readmitted to the hospital within a matter of weeks will continue to rise in response to poor discharge procedures, inadequate follow-up care and unnecessary healthcare utilization. Fortunately, a growing number of physicians and healthcare facilities are moving toward models of accountable care and adopting telehealth as an effective tool for managing patient safety, improving discharge procedures and optimizing after-care in order to keep costs down and realize greater shared savings. It's about bridging the gap between theoretical availability and realistic accessibility. By linking the patient to a comprehensive network of physicians, specialists and healthcare professionals, 24/7/365, telehealth delivers rapid access to care for patients when and where they need it.
A successful entrepreneur for the past 15 years, as CEO of InteractiveMD Jesse Kessler has structured and fortified many prominent partnerships, with the goal of growing the company's technologies, processes and networks, and delivering efficient, affordable and accessible healthcare. He is also the founder of Global Pharmaceutical Sourcing, a specialty pharmaceutical distribution business selling to hospitals, home infusions centers, surgery centers, blood banks, and other providers.
Footnotes:
[1] Minott, Jenny; Reducing Hospital Readmissions; Academy Health; November 2008; http://www.academyhealth.org/files/publications/ReducingHospitalReadmissions.pdf; accessed May 18, 2012.
[2] Abelson, Reed; Study finds many on Medicare Return to Hospital; New York Times; April1, 2009; http://www.nytimes.com/2009/04/02/health/02hospital.html?_r=2; accessed May 21, 2012.
[3] Gibson, Jackie Walker; Telehealth Could Boost Outcomes, Reduce Readmissions; Ignite; February 14, 2012; http://ignite.optuminsight.com/archive/telehealth-could-boost-outcomes-and-reduce-readmissions/; accessed May 21, 2012.
[4] Jennett, P. A., et al; The socio-economic impact of telehealth: a systemic review; Journal of Telemedicine and Telecare; December 1, 2003; http://www.jtt.rsmjournals.com/content/9/6/311.short; accessed May 21, 2012.
[5] Dixon, Brian E. et al; US Department of Health and Human Services; Using telehealth to improve quality and safety; December 2008; http://healthit.ahrq.gov/images/dec08telehealthreport/telehealth_issue_paper.htm; accessed May 21, 2012.
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